Salary
≈ $168k – $290k per year (Estimated)
Location
Remote (United States)
Seniority
Architect
Employment
Full-Time
Overview
Company
Impact
Profile match
Healthcare needs a rebuild, not just a renovation. That's why we are creating a new system that connects providers directly with employers and patients to cut costs and wasted time.
What You'll Do:
- Market solution design. Partner with network, go-to-market, and sales teams to define and scope what Nomi can realistically deliver in each new market before it's sold, including provider coverage, TPA capability, and integration sequencing.
- Partner and TPA data exchange. Write the integration requirements between Nomi and every partner in the claim lifecycle - inbound claims, priced output, remittance, eligibility, file cadence, SLAs, and reconciliation - specific enough that an engineer on either side can build to it.
- Network configuration and pricing. Own the path from a signed rate sheet to a correctly priced claim: ingestion, normalization, versioning, effective dating, validation, and audit. Set the testing and release bar for anything that touches pricing.
- Provider data, adequacy, and directory. Own the provider data model and hierarchy - sponsor, tax ID, billing NPI, service location - and make network adequacy and directory accuracy measurable rather than asserted.
- New segments and group types. Evaluate new group types and segments as they come up, be willing to recommend against ones that don't fit, and defend that recommendation to sales.
- The payments interface. Recognize when a network change has payment-side consequences and get ahead of it with the financial services and payments teams before it ships.
What We're Looking For:
- Reimbursement fluency. You understand the difference between billed, allowed, and paid, and you've worked hands-on with real fee schedules and rate methodologies, percent-of-Medicare, per diem, case rate, DRG, percent-of-charge.
- Domain background. You've built this expertise at a health plan, a TPA, a repricing or payment-integrity vendor, a reference-based-pricing administrator, a provider revenue-cycle organization, or a network contracting organization.
- Data exchange experience. You're comfortable with 837, 835, and eligibility file exchange, and you've written integration requirements that another team was able to build from successfully.
- Commercial confidence. You're comfortable representing Nomi directly in front of a broker, a TPA executive, or a health system, and making commitments you can stand behind.
- A self-directed approach. You're comfortable defining your own priorities and figuring out what matters most, rather than working off a pre-built roadmap.
- Enough technical fluency to be credible. You can read a data model, write SQL against it, and give an engineer clear enough direction that they're not left guessing. You won't be writing production code yourself.
- Strong written communication. Requirements documents are a core part of this role, so your writing should be clear, specific, and easy for others to build from.
Preferred Experiences:
- Experience in self-funded employer health: TPA administration, direct contracting, reference-based pricing, or captives.
- You've run a platform migration or a vendor claims-system implementation and lived through the reporting gap that follows.
- Founder or early-operator background, or a track record of using automation and AI to replace manual operational work.
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